Sleep Health | Sleep Review
A new study led by researchers at Brigham and Women’s Hospital looked at data from white, black, Chinese, and Hispanic adults in the United States and measured various aspects of their sleep using actigraphy, self-reports, and polysomnography. The team found clear differences, with the highest sleep health observed in the white group and the lowest observed in the black group. Chinese and Hispanic groups had intermediate results. When investigating the causes of these differences in sleep health, investigators found that black and Hispanic adults were less likely than white adults to have adequate sleep lengths and were more likely to have high night-to-night bedtime variability. Their results are published in the American Journal of Epidemiology.
“Insufficient sleep has been linked over time to mortality, cardiovascular disease, and some adverse health outcomes,” Joon Chung, PhD, research fellow in Brigham’s Sleep and Circadian Disorders Division, said in a press release. “If we could close the sleep gap, we could potentially start bridging the gap in other outcomes, such as mortality and cardiovascular disease, and indirectly helping to reduce health inequalities.”
The new study used data from the Multi-Ethnic Study of Atherosclerosis (MESA) to compare groups of white, black, Chinese, and Hispanic adults in the United States. The research team found this dataset particularly beneficial because it focuses on racial-ethnic minorities. While many sleep studies rely solely on self-reports, MESA’s additional use of actigraphy and polysomnography ensured a comprehensive data set.
“Using MESA data from over 1,700 adults, we created a global sleep health risk score that consists of measurements of sleep duration (how much we sleep), when we sleep (when we sleep), and sleep quality (self-reported and objectively measured depth of sleep ) composed. Slow wave sleep), sleep continuity, and sleep apnea, ”said Susan Redline, MD, MPH, of Brigham’s Division of Sleep and Circadian Disorders in a press release.
Using the sleep measurements, the team found that the biggest differences in sleep health were between white and black adults. In addition, black and Hispanic adults were less likely to have had adequate sleep lengths than white adults. Black and Hispanic adults were also more likely to show fluctuations in sleep patterns from night to night. When analyzing irregular timing and duration, insufficient duration, and fragmented sleep, large racial-ethnic disparities were found. The research team took a particular interest in sleep irregularities and found that they are a driving force behind these inequalities.
“Theoretically, irregularities can be intervened and corrected. We actually have regular sleep hygiene measures, ”says Chung. “So, I think that’s one of the more exciting parts of it because it’s not just about identifying the problem, but also that there are some solutions that are already in place.”
The authors point out that sleep is holistic and therefore many factors contribute to good sleep health. Black, Hispanic, and Asian adults are more likely to have poor sleep risk factors such as unstable work schedules, less safe neighborhoods, environments with more light or noise, and increased stress. The researchers hope this study will raise awareness of racial-ethnic sleep differences among clinicians when treating non-white patients.
“Our research shows that sleep problems are prevalent among non-white populations and suggests that clinicians should consider screening everyone for sleep problems as these are intervening factors that can then cause other health inequalities,” says Redline .
While the MESA data is comprehensive, the adults we studied came from just six US cities. The authors recognized that the factors influencing racial ethnic minorities in sleep can vary by geography, making greater coverage an important next step. The study was also exclusive to older adults, with a mean age of 68.3 years. The researchers found that looking at a younger population could reveal different patterns. In the future, the team would like to see more specific research on populations that have not been studied.
“This research shows that global sleep health can help track and inform health differences,” says Redline. “In addition, the results underscored the need for public health efforts to improve adequate and even sleep for minority groups in order to reduce the disparities in sleep health and thus improve health.”
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